WO2014189835A2 - Greffons anti-thrombose - Google Patents

Greffons anti-thrombose Download PDF

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Publication number
WO2014189835A2
WO2014189835A2 PCT/US2014/038597 US2014038597W WO2014189835A2 WO 2014189835 A2 WO2014189835 A2 WO 2014189835A2 US 2014038597 W US2014038597 W US 2014038597W WO 2014189835 A2 WO2014189835 A2 WO 2014189835A2
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WO
WIPO (PCT)
Prior art keywords
layer
decellularized
coating
substrate
heparin
Prior art date
Application number
PCT/US2014/038597
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English (en)
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WO2014189835A3 (fr
Inventor
Sashka DIMITRIEVSKA
Laura Niklason
Original Assignee
Yale University
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to DK14800261.1T priority Critical patent/DK2999494T3/da
Priority to CN201480029024.8A priority patent/CN105228665A/zh
Priority to AU2014268778A priority patent/AU2014268778B2/en
Priority to CA2912664A priority patent/CA2912664C/fr
Priority to EP14800261.1A priority patent/EP2999494B1/fr
Priority to ES14800261T priority patent/ES2829412T3/es
Application filed by Yale University filed Critical Yale University
Priority to US14/783,897 priority patent/US9981066B2/en
Publication of WO2014189835A2 publication Critical patent/WO2014189835A2/fr
Publication of WO2014189835A3 publication Critical patent/WO2014189835A3/fr
Priority to HK16107327.1A priority patent/HK1219242A1/zh
Priority to US15/963,750 priority patent/US20180243482A1/en
Priority to AU2018271341A priority patent/AU2018271341B2/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L27/507—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials for artificial blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
    • A61K31/715—Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
    • A61K31/726—Glycosaminoglycans, i.e. mucopolysaccharides
    • A61K31/727—Heparin; Heparan
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/28—Materials for coating prostheses
    • A61L27/34—Macromolecular materials
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
    • A61L27/3604—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix characterised by the human or animal origin of the biological material, e.g. hair, fascia, fish scales, silk, shellac, pericardium, pleura, renal tissue, amniotic membrane, parenchymal tissue, fetal tissue, muscle tissue, fat tissue, enamel
    • A61L27/3625—Vascular tissue, e.g. heart valves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L27/52—Hydrogels or hydrocolloids
    • A—HUMAN NECESSITIES
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    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L27/54—Biologically active materials, e.g. therapeutic substances
    • A—HUMAN NECESSITIES
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    • A61L33/00—Antithrombogenic treatment of surgical articles, e.g. sutures, catheters, prostheses, or of articles for the manipulation or conditioning of blood; Materials for such treatment
    • A61L33/0005—Use of materials characterised by their function or physical properties
    • A61L33/0011—Anticoagulant, e.g. heparin, platelet aggregation inhibitor, fibrinolytic agent, other than enzymes, attached to the substrate
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    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L33/00—Antithrombogenic treatment of surgical articles, e.g. sutures, catheters, prostheses, or of articles for the manipulation or conditioning of blood; Materials for such treatment
    • A61L33/0005—Use of materials characterised by their function or physical properties
    • A61L33/0011—Anticoagulant, e.g. heparin, platelet aggregation inhibitor, fibrinolytic agent, other than enzymes, attached to the substrate
    • A61L33/0029—Anticoagulant, e.g. heparin, platelet aggregation inhibitor, fibrinolytic agent, other than enzymes, attached to the substrate using an intermediate layer of polymer
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    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L33/00—Antithrombogenic treatment of surgical articles, e.g. sutures, catheters, prostheses, or of articles for the manipulation or conditioning of blood; Materials for such treatment
    • A61L33/0005—Use of materials characterised by their function or physical properties
    • A61L33/0064—Hydrogels or hydrocolloids
    • A—HUMAN NECESSITIES
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    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L33/00—Antithrombogenic treatment of surgical articles, e.g. sutures, catheters, prostheses, or of articles for the manipulation or conditioning of blood; Materials for such treatment
    • A61L33/06—Use of macromolecular materials
    • A61L33/08—Polysaccharides
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B05—SPRAYING OR ATOMISING IN GENERAL; APPLYING FLUENT MATERIALS TO SURFACES, IN GENERAL
    • B05D—PROCESSES FOR APPLYING FLUENT MATERIALS TO SURFACES, IN GENERAL
    • B05D7/00—Processes, other than flocking, specially adapted for applying liquids or other fluent materials to particular surfaces or for applying particular liquids or other fluent materials
    • B05D7/50—Multilayers
    • B05D7/52—Two layers
    • B05D7/54—No clear coat specified
    • C—CHEMISTRY; METALLURGY
    • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
    • C08B—POLYSACCHARIDES; DERIVATIVES THEREOF
    • C08B37/00—Preparation of polysaccharides not provided for in groups C08B1/00 - C08B35/00; Derivatives thereof
    • C08B37/006—Heteroglycans, i.e. polysaccharides having more than one sugar residue in the main chain in either alternating or less regular sequence; Gellans; Succinoglycans; Arabinogalactans; Tragacanth or gum tragacanth or traganth from Astragalus; Gum Karaya from Sterculia urens; Gum Ghatti from Anogeissus latifolia; Derivatives thereof
    • C08B37/0063—Glycosaminoglycans or mucopolysaccharides, e.g. keratan sulfate; Derivatives thereof, e.g. fucoidan
    • C08B37/0072—Hyaluronic acid, i.e. HA or hyaluronan; Derivatives thereof, e.g. crosslinked hyaluronic acid (hylan) or hyaluronates
    • C—CHEMISTRY; METALLURGY
    • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
    • C08B—POLYSACCHARIDES; DERIVATIVES THEREOF
    • C08B37/00—Preparation of polysaccharides not provided for in groups C08B1/00 - C08B35/00; Derivatives thereof
    • C08B37/006—Heteroglycans, i.e. polysaccharides having more than one sugar residue in the main chain in either alternating or less regular sequence; Gellans; Succinoglycans; Arabinogalactans; Tragacanth or gum tragacanth or traganth from Astragalus; Gum Karaya from Sterculia urens; Gum Ghatti from Anogeissus latifolia; Derivatives thereof
    • C08B37/0063—Glycosaminoglycans or mucopolysaccharides, e.g. keratan sulfate; Derivatives thereof, e.g. fucoidan
    • C08B37/0075—Heparin; Heparan sulfate; Derivatives thereof, e.g. heparosan; Purification or extraction methods thereof
    • C—CHEMISTRY; METALLURGY
    • C09—DYES; PAINTS; POLISHES; NATURAL RESINS; ADHESIVES; COMPOSITIONS NOT OTHERWISE PROVIDED FOR; APPLICATIONS OF MATERIALS NOT OTHERWISE PROVIDED FOR
    • C09D—COATING COMPOSITIONS, e.g. PAINTS, VARNISHES OR LACQUERS; FILLING PASTES; CHEMICAL PAINT OR INK REMOVERS; INKS; CORRECTING FLUIDS; WOODSTAINS; PASTES OR SOLIDS FOR COLOURING OR PRINTING; USE OF MATERIALS THEREFOR
    • C09D105/00—Coating compositions based on polysaccharides or on their derivatives, not provided for in groups C09D101/00 or C09D103/00
    • C09D105/08—Chitin; Chondroitin sulfate; Hyaluronic acid; Derivatives thereof
    • C—CHEMISTRY; METALLURGY
    • C09—DYES; PAINTS; POLISHES; NATURAL RESINS; ADHESIVES; COMPOSITIONS NOT OTHERWISE PROVIDED FOR; APPLICATIONS OF MATERIALS NOT OTHERWISE PROVIDED FOR
    • C09D—COATING COMPOSITIONS, e.g. PAINTS, VARNISHES OR LACQUERS; FILLING PASTES; CHEMICAL PAINT OR INK REMOVERS; INKS; CORRECTING FLUIDS; WOODSTAINS; PASTES OR SOLIDS FOR COLOURING OR PRINTING; USE OF MATERIALS THEREFOR
    • C09D105/00—Coating compositions based on polysaccharides or on their derivatives, not provided for in groups C09D101/00 or C09D103/00
    • C09D105/10—Heparin; Derivatives thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
    • A61K35/44—Vessels; Vascular smooth muscle cells; Endothelial cells; Endothelial progenitor cells
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/20—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices containing or releasing organic materials
    • A61L2300/23—Carbohydrates
    • A61L2300/236—Glycosaminoglycans, e.g. heparin, hyaluronic acid, chondroitin
    • A—HUMAN NECESSITIES
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    • A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/40—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
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    • A—HUMAN NECESSITIES
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    • A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/60—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a special physical form
    • A61L2300/606—Coatings
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    • A61L2430/00—Materials or treatment for tissue regeneration
    • A61L2430/40—Preparation and treatment of biological tissue for implantation, e.g. decellularisation, cross-linking

Definitions

  • Vascular grafting is the use of transplanted blood vessels or synthetic scaffolds to replace, repair, or bypass damaged or potentially dangerous vessels.
  • Vascular grafts are implanted into subjects with a wide variety of diseases and disorders, including cardiovascular disease, atherosclerosis, peripheral vascular disease, abdominal aortic aneurysm, and the like. These grafts can improve or restore blood flow to regions in which flow is obstructed.
  • cardiovascular disease atherosclerosis
  • peripheral vascular disease vascular disease
  • abdominal aortic aneurysm abdominal aortic aneurysm, and the like.
  • These grafts can improve or restore blood flow to regions in which flow is obstructed.
  • autologous vessels or synthetic vessels made from biocompatible materials are traditionally used today, there has been some development in the use of decellularized structures as vascular grafts.
  • Decellularized vascular grafts retain the shape and structure of native vessels, but are devoid of cells, thereby minimizing the immunogenicity of the graft
  • the present invention includes anti-thrombogenic compositions, such as anti-thrombogenic vascular grafts, compositions comprising decellularized tissue coated with an anti-thrombogenic coating, methods of preparing anti-thrombogenic compositions, and methods of treatment comprising implanting the anti-thrombogenic compositions into a subject in need thereof.
  • anti-thrombogenic compositions such as anti-thrombogenic vascular grafts, compositions comprising decellularized tissue coated with an anti-thrombogenic coating, methods of preparing anti-thrombogenic compositions, and methods of treatment comprising implanting the anti-thrombogenic compositions into a subject in need thereof.
  • One aspect of the invention includes a composition comprising a substrate having at least one surface coated with an anti-thrombogenic coating.
  • Another aspect includes a method of preparing a graft coated with an anti-thrombogenic coating, comprising the steps of: providing a substrate having at least one surface; and coating the at least one surface with an anti-thrombogenic coating, wherein said coating comprises: applying a first crosslinking solution to the surface; and applying a hydrogel solution to the surface, thereby providing a first layer on the surface of the substrate.
  • the invention includes a method of treating a diseased blood vessel in a subject, comprising bypassing the diseased blood vessel by implanting into the subject an anti-thrombogenic vascular graft, comprising a substrate having a luminal surface coated with an anti-thrombogenic coating.
  • the invention includes a method of providing vascular access in a subject, comprising implanting into the subject an anti- thrombogenic vascular graft, comprising a substrate having a luminal surface coated with an anti-thrombogenic coating.
  • the anti-thrombogenic coating comprises a first layer comprising a hydrogel.
  • the first layer comprises hyaluronic acid, such as a thiol-modified hyaluronic acid.
  • the first layer is crosslinked to the at least one surface of the substrate, such as the luminal surface of the substrate.
  • the hydrogel solution comprises hyaluronic acid.
  • the anti-thrombogenic coating further comprises a second layer comprising an anti-coagulant, wherein the second layer is crosslinked to the first layer.
  • the second layer comprises heparin.
  • the anti-coagulant solution comprises heparin.
  • the substrate is a decellularized tissue, such as a decellularized blood vessel.
  • the decellularized tissue is a decellularized blood vessel having a luminal surface, and wherein the anti- thrombogenic coating is coated on the luminal surface of the decellularized blood vessel.
  • the coating further comprises applying a second crosslinking solution to the first layer and applying an anti-coagulant solution to the first layer, thereby providing a second layer atop the first layer.
  • the subject has a disorder selected from the group consisting of peripheral vascular disease, atherosclerosis, aneurysm, and venous thrombosis.
  • the subject is undergoing or is anticipated to undergo hemodialysis.
  • Figure 1 is a schematic description of HA-heparin based coating of decellularized grafts structures, using thiolated-HA as a first layer of coating and "end-on" aminated heparin as a second layer of the coating.
  • Figure 2A depicts the schematic description of heparin modification for "end-on" heparin modification and Sulfo-SMCC addition for spontaneous heparin crosslinking onto hyaluronic acid coated decellularized vessels.
  • Figure 2B depicts the NMR characterization of heparin modification.
  • Figure 3 is a set of images depicting the cross-sections of HA coated decellularized porcine abdominal aortas using increasing concentrations of
  • SM(PEG) i2 crosslinker NHS-maleimide crosslinker
  • concentration of the crosslinker increases, so does the coating smoothness and thickness as demonstrated by the increasing thick layer of blue dye on the surface (Toluidine Blue), and orange dye layer (Alamar Blue pH 1).
  • the coating is indicated by arrows in both Toluidine Blue and Alamar Blue pH 1 (AB pH 1).
  • Figure 4 is a set of images depicting the birds-eye view SEM images of control decellularized rat abdominal aortas (aortas that are decellularized with no further treatment), hyaluronic acid coated decellularized aortas, and layer-by-layer hyaluronic acid -heparin coated aortas.
  • Figure 5 is an image depicting a SEM cross-section of entire tubular decellularized rat abdominal aortas layer-by-layer HA-heparin coated. The coating can be clearly seen on the luminal side of the vessels as a few microns thick layer as indicated by white arrow.
  • Figure 6 is a set of images depicting histological sections of entire tubular control rat abdominal aortas (decellularized aortas with no further treatment), and layer-by-layer hyaluronic acid- heparin coated decellularized aortas.
  • the sections were stained with Toluidine Blue, Alcian Blue pHl, and Alcian Blue PAS.
  • the coating can be clearly seen on the luminal side of the vessels as a few microns thick layer.
  • Figure 7 is a set of SEM images of platelets isolated from rat blood incubated on decellularized control rat abdominal aortas, hyaluronic acid coated and layer-by-layer hyaluronic acid-heparin coated decellularized aortas. The platelets and thrombus formation are clearly visible on the control. The treated vessels show complete absence of platelets adhesion.
  • Figure 8 is a set of images depicting the results from experiments where platelets were phalloidin stained (which produces a red color in the platelets), incubated on decellularized control rat abdominal aortas, and layer-by-layer hyaluronic acid -heparin coated decellularized aortas. The platelets are clearly visible on the control aorta. The coated aortas show an absence of platelets.
  • Figure 9 is a graph depicting the determination of functional surface heparin via the Factor X assay where the heparin effects on Factor X inactivation are expressed in back-calculated heparin equivalent weights.
  • the assayed samples were: decellularized control aortas, freshly excised native rat aorta with a continuous layer of endothelial cells preserved, a cultured continuous monolayer of HUVECs, and decellularized rat aortas hyaluronic acid -heparin coated.
  • FIG 10 is an image depicting the results of experiments wherein HUVECs were plated on HA-heparin layer-by-layer coated aortas and cultured for 2 weeks.
  • the HUVECs cytoskeleton was stained with phalloidin (red) and HUVECs nucleus was stained with DAPI (blue) and imaged over a ⁇ z-stack.
  • the x and y axis are shown on the sides of the image where the HUVECs are seen growing a non- planar monolayer. The HUVECs can be seen invading the coating.
  • Figure 11 is a panel of graphs showing storage modulus (G " full circles) and loss modulus (C open circles) of HA gels and HA- PEG crosslinker incubated onto decellularized porcine aorta plotted as a function of time.
  • Panels A and B display the Hyaluronic acid loaded onto decellularized porcine aorta in the absence of the PEG crosslinker and where the elastic (G') and loss (G") moduli are plotted against time in Log (panel A) or Ln (panel B).
  • Panels C and D display the Hyaluronic acid loaded onto decellularized porcine aorta with the addition of PEG crosslinker.
  • the elastic (G') and loss (G") moduli are plotted against time in Log (panel C) or Ln (panel D).
  • the storage modulus G was calculated to be 37 kPa for the HA-PEG and 2 kPa for the HA gels without the PEG crosslinker at 80% polymerized form of the gels using the complex storage modulus equation above.
  • the HA-PEG gels attain their mature cross-linked form within 4 hours of incubation and the HA gels alone attain a mature form within 23 hours of incubation. This indicated that after at least 4 hours of luminal perfusion of the HA gels within the vessels should have fully polymerized coatings.
  • Figure 12 is a panel of images showing decellularized rat aortas uncoated control (left-hand panel of images) and decellularized rat aortas Hyaluronic Acid/ Heparin coated (right-hand panel of images) stability evaluation at 37°C for two weeks incubated under PBS (panel A) and freshly drawn rat plasma (panel B).
  • Figure 13 is panel of images showing HUVECs seeded onto the three different coating layers deposited stained with DAPI (blue) and VE-Cadherin (red) after three days of culture.
  • the coating components are biocompatible and support endothelial cell growth and proliferation in vitro on short time periods.
  • Figure 14 is a panel of images showing cross-sections of rat- decellularized grafts implanted end-to-end in rat abdominal aortas at after 4 weeks of implantation.
  • the top panel shows an example of the control group where the implanted graft was a decellularized rat aorta without further modification.
  • the bottom panel shown an example of Hylaronic acid coated rat decellularized graft implanted end-to-end in rat abdominal aorta 4 weeks after implantation. All the sections were stained with hematoxylin and eosin (H&E) showing the migration of abluminal cells within the grafts and the cellular deposition within the large blood clot of the control group rat.
  • H&E hematoxylin and eosin
  • Figure 15 is a panel of images showing explants and Doppler ultrasound imaging assessment of graft patency at week 4.
  • Top panel is the control decellularized rat aorta and the bottom panel is the Hyaluronic Acid coated decellularized rat aorta.
  • Control implants showed no flow recording as per the Doppler ultrasound imaging where a flat line is indicative of the absence of flow.
  • the picture of the explant shown a large fibrotic blood clot well formed in the center of the implant preventing any blood flow through the graft.
  • the graft is also dilated to 20X its original size which indicates that the graft wall were probably week and a large anastomosis formation.
  • Hyaluronic Acid coated rat decellularized aortas (bottom panel) Doppler recording shows the typical rat pulsatile flow indicative of healthy vascular flow and typical rat aorta flow readouts of 30 cm/s velocity peak.
  • the explant picture shows the absence of luminal occlusions, clots and blockages and sown that the graft is within the implanted dimensions of 2 mm diameter indicating the absence of dilatation.
  • Figure 16 is a panel of images showing cross-sections of TEVG- decellularized implanted end-to-side in dog carotid arteries at after 4 weeks of implantation.
  • the top panel shows an example of the control group where the implanted graft was a decellularized TEVG without further modification.
  • the bottom panel shown an example of Hyaluronic acid coated decellularized TEVG. All the sections were stained with hematoxylin and eosin (H&E). The absence of blood clots and occlusions is seen in the coated grafts and the deposition of endothelial cells is also visible on the Hyaluronic acid-heparin-coated grafts.
  • H&E hematoxylin and eosin
  • the present invention relates to anti-thrombogenic coated compositions, methods of preparing such compositions, and methods of using such compositions.
  • the present invention provides vascular grafts coated with an anti-thrombogenic coating.
  • the present invention is based upon the discovery that coating the luminal surface of a decellularized blood vessel with a layer of hyaluronic acid (HA) or a multilayer coating of HA and heparin or other molecules prevents thrombogenesis in the vessel.
  • HA hyaluronic acid
  • the invention provides an anti-thrombogenic vascular graft composition comprising a decellularized blood vessel wherein the luminal surface of the blood vessel is coated with an HA layer.
  • the invention provides an anti- thrombogenic vascular graft composition
  • a decellularized blood vessel wherein the luminal surface of the blood vessel is coated with a multilayer coating where at least one layer comprises HA and at least one other layer comprises heparin.
  • the HA layer is crosslinked to the luminal surface of the vessel.
  • the heparin layer is crosslinked to the HA layer.
  • one or more layers of the coating comprise a hydrogel.
  • the HA layer is bound to other blood contacting surfaces, such as plastics contained in vascular grafts or catheters, or native vasculature that conducts blood.
  • the invention further provides methods of treatment comprising implanting an anti-thrombogenic composition of the invention to a recipient.
  • the method comprises implanting a HA-coated or HA- heparin-coated vascular graft into a subject in need thereof.
  • the coated vascular graft can be used, for example, to treat a subject having a diseased or blocked blood vessel.
  • the coated vascular graft is used in a method of treating an aneurysm.
  • the coated vascular graft is used in a method of bypassing a diseased or blocked vessel.
  • the coated vascular graft is used in a method of providing vascular access in a subject undergoing or anticipated to undergo hemodialysis.
  • abnormal when used in the context of organisms, tissues, cells or components thereof, refers to those organisms, tissues, cells or components thereof that differ in at least one observable or detectable characteristic (e.g., age, treatment, or time of day) from those organisms, tissues, cells or components thereof that display the "normal” (expected) respective characteristic. Characteristics that are normal or expected for one cell or tissue type might be abnormal for a different cell or tissue type.
  • “About” as used herein when referring to a measurable value such as an amount, a temporal duration, and the like, is meant to encompass variations of ⁇ 20% or ⁇ 10%, more preferably ⁇ 5%, even more preferably ⁇ 1%, and still more preferably ⁇ 0.1% from the specified value, as such variations are appropriate to perform the disclosed methods.
  • to "alleviate" a disease, defect, disorder or condition means reducing the severity of one or more symptoms of the disease, defect, disorder or condition.
  • anti-coagulant refers to an agent or class of agents that prevents coagulation or clotting of blood.
  • anti-thrombogenic coating refers to a coating that reduces thrombus or blood clot formation.
  • autologous refers to a biological material derived from the same individual into whom the material will later be re-introduced.
  • allogeneic refers to a biological material derived from a genetically different individual of the same species as the individual into whom the material will be introduced.
  • biocompatible refers to any material, which, when implanted in a mammal, does not provoke an adverse response in the mammal.
  • a biocompatible material when introduced into an individual, is not toxic or injurious to that individual, nor does it induce immunological rejection of the material in the mammal.
  • biocompatible polymers include polymers that are generally neither toxic to the host, nor degrade (if the polymer degrades) at a rate that produces monomeric or oligomeric subunits or other byproducts at toxic concentrations in the host.
  • biodegradation generally involves degradation of the polymer in a host, e.g., into its monomeric subunits, which may be known to be effectively non-toxic. Intermediate oligomeric products resulting from such degradation may have different toxicological properties, however, or biodegradation may involve oxidation or other biochemical reactions that generate molecules other than monomeric subunits of the polymer.
  • toxicology of a biodegradable polymer intended for in vivo use may be determined after one or more toxicity analyses. It is not necessary that any subject composition have a purity of 100% to be deemed biocompatible; indeed, it is only necessary that the subject compositions be biocompatible as set forth above.
  • a subject composition may comprise polymers comprising 99%, 98%, 97%, 96%, 95%, 90%, 85%, 80%, 75% or even less of biocompatible polymers, e.g., including polymers and other materials and excipients described herein, and still be
  • biologically compatible carrier or “biologically compatible medium” refers to reagents, cells, compounds, materials, compositions, and/or dosage formulations which are suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other complication commensurate with a reasonable benefit/risk ratio.
  • coating refers to a covering that is applied to the surface of an object, usually a substrate.
  • the coating may be continuous or non- continuous over the surface of the substrate.
  • the coating may have one or more layers.
  • crosslinking is meant creating a bond that links one polymer chain to another.
  • Crosslinking may be induced through a crosslinking agent, solution or source or may be induced through self-assembly.
  • crosslinking agent or “crosslinking source” is meant an agent that is capable of forming a chemical or ionic links between molecules.
  • crosslinking agents or sources include calcium chloride; ammonium persulfate (APS) and tetramethylethylenediamine (TEMED), glutaraldehyde, epoxides, oxidized dextran, p-azidobenzoyl hydrazide, N-[a.- maleimidoacetoxyjsuccinimide ester, p-azidophenyl glyoxal monohydrate, bis-[p-(4- azidosalicylamido)ethyl]disulfide, bis[sulfosuccinimidyl]suberate,
  • crosslinking solution is meant a crosslinking agent in a solution or solvent.
  • decellularized refers to a biostructure (e.g., an organ, or part of an organ, or a tissue), from which the cellular content has been removed leaving behind an intact acellular infra-structure.
  • a biostructure e.g., an organ, or part of an organ, or a tissue
  • Some organs are composed of various specialized tissues.
  • the specialized tissue structures of an organ, or parenchyma provide the specific function associated with the organ.
  • the supporting fibrous network of the organ is the stroma.
  • Most organs have a stromal framework composed of unspecialized connecting tissue which supports the specialized tissue.
  • the process of decellularization removes the specialized tissue cells, leaving behind the complex three-dimensional network of extracellular matrix.
  • the connective tissue infra- structure is primarily composed of collagen.
  • the decellularized structure provides a biocompatible substrate onto which different cell populations can be infused.
  • Decellularized biostructures can be rigid, or semi-rigid, having an ability to alter their
  • extracellular matrix composition includes both soluble and non-soluble fractions or any portion thereof.
  • the non-soluble fraction includes those secreted ECM proteins and biological components that are deposited on the support or scaffold.
  • the soluble fraction includes refers to culture media in which cells have been cultured and into which the cells have secreted active agent(s) and includes those proteins and biological components not deposited on the scaffold. Both fractions may be collected, and optionally further processed, and used individually or in combination in a variety of applications as described herein.
  • the term "gel” refers to a three-dimensional polymeric structure that itself is insoluble in a particular liquid but which is capable of absorbing and retaining large quantities of the liquid to form a stable, often soft and pliable, but always to one degree or another shape-retentive, structure.
  • the gel is referred to as a hydrogel.
  • a "graft” refers to a composition that is implanted into an individual, typically to replace, correct or otherwise overcome a cell, tissue, or organ defect.
  • a graft may comprise a scaffold.
  • a graft comprises decellularized tissue.
  • the graft may comprise a cell, tissue, or organ.
  • the graft may consist of cells or tissue that originate from the same individual; this graft is referred to herein by the following interchangeable terms: "autograft,” “autologous transplant,” “autologous implant” and “autologous graft.”
  • a graft comprising cells or tissue from a genetically different individual of the same species is referred to herein by the following interchangeable terms: “allograft,” “allogeneic transplant,” “allogeneic implant” and “allogeneic graft.”
  • a graft from an individual to his identical twin is referred to herein as an “isograft,” a "syngeneic transplant,” a “syngeneic implant” or a “syngeneic graft.”
  • xenogeneic transplant or “xenogeneic implant” refers to a graft from one individual to another of a different species.
  • the term "intact” refers to a state of being whereby an element is capable of performing its original function to a substantial extent.
  • Photo-crosslinking refers to bond formation that links one polymer chain to another upon exposure to light of appropriate wavelengths.
  • two polymers conjugated to a photoreactive group can be covalently photo-crosslinked by covalent bond formation between the photoreactive groups.
  • polymerization refers to at least one reaction that consumes at least one functional group in a monomeric molecule (or monomer), oligomeric molecule (or oligomer) or polymeric molecule (or polymer), to create at least one chemical linkage between at least two distinct molecules (e.g., intermolecular bond), at least one chemical linkage within the same molecule (e.g., intramolecular bond), or any combination thereof.
  • a polymerization or cross-linking reaction may consume between about 0% and about 100% of the at least one functional group available in the system. In one embodiment, polymerization or cross-linking of at least one functional group results in about 100% consumption of the at least one functional group.
  • polymerization or cross- linking of at least one functional group results in less than about 100% consumption of the at least one functional group.
  • scaffold refers to a structure, comprising a biocompatible material that provides a surface suitable for adherence and proliferation of cells.
  • a scaffold may further provide mechanical stability and support.
  • a scaffold may be in a particular shape or form so as to influence or delimit a three-dimensional shape or form assumed by a population of proliferating cells.
  • Such shapes or forms include, but are not limited to, films (e.g. a form with two-dimensions substantially greater than the third dimension), ribbons, cords, sheets, flat discs, cylinders, spheres, 3-dimensional amorphous shapes, etc.
  • substrate refers to a supporting material.
  • surface refers to the outer most layer of a substrate or outermost part of the substrate.
  • thiol-modified refers to one or more modifications to the substrate.
  • to "treat” means reducing the frequency with which symptoms of a disease, defect, disorder, or adverse condition, and the like, are experienced by a patient.
  • tissue includes, but is not limited to, bone, neural tissue, fibrous connective tissue including tendons and ligaments, cartilage, dura, pericardia, muscle, lung, heart valves, veins and arteries and other vasculature, dermis, adipose tissue, or glandular tissue.
  • scaffold refers to a structure, comprising a biocompatible material that provides a surface suitable for adherence of a substance.
  • a scaffold may further provide mechanical stability and support.
  • a scaffold may be in a particular shape or form so as to influence or delimit a three-dimensional shape or form.
  • Such shapes or forms include, but are not limited to, films (e.g. a form with two-dimensions substantially greater than the third dimension), ribbons, cords, sheets, flat discs, cylinders, spheres, 3-dimensional amorphous shapes, etc.
  • a subject is preferably a mammal such as a non- primate (e.g., cows, pigs, horses, cats, dogs, rats, etc.) and a primate (e.g., monkey and human), most preferably a human.
  • a non- primate e.g., cows, pigs, horses, cats, dogs, rats, etc.
  • a primate e.g., monkey and human
  • treating a disease or disorder means reducing the frequency with which a symptom of the disease or disorder is experienced by a patient.
  • Disease and disorder are used interchangeably herein.
  • therapeutically effective amount refers to an amount that is sufficient or effective to prevent or treat (delay or prevent the onset of, prevent the progression of, inhibit, decrease or reverse) a disease or condition described or contemplated herein, including alleviating symptoms of such disease or condition.
  • the term "effective amount” or “therapeutically effective amount” of a compound is that amount of compound that is sufficient to provide a beneficial effect to the subject to which the compound is administered.
  • ranges throughout this disclosure, various aspects of the invention can be presented in a range format. It should be understood that the description in range format is merely for convenience and brevity and should not be construed as an inflexible limitation on the scope of the invention. Accordingly, the description of a range should be considered to have specifically disclosed all the possible subranges as well as individual numerical values within that range. For example, description of a range such as from 1 to 6 should be considered to have specifically disclosed subranges such as from 1 to 3, from 1 to 4, from 1 to 5, from 2 to 4, from 2 to 6, from 3 to 6 etc., as well as individual numbers within that range, for example, 1, 2, 2.7, 3, 4, 5, 5.3, and 6. This applies regardless of the breadth of the range. Description
  • the present invention relates to compositions coated with an anti- thrombogenic coating, methods of making such compositions, and methods of using such compositions.
  • the invention relates to biomaterials, tissue engineered constructs, and the like, which are coated with an anti-thrombogenic coating.
  • the present invention provides vascular grafts coated with an anti-thrombogenic coating.
  • the present invention is not limited to any particular type of material or construct. Rather, the present invention encompasses any material or construct coated with the anti- thrombogenic coating of the invention.
  • the present invention is based upon the discovery that coating the luminal surface of a decellularized blood vessel with a layer of hyaluronic acid (HA) or a multilayer coating of HA and heparin or other molecules prevents
  • the present invention is directed to a chemical coating, in lieu of cell seeding, to provide an anti-thrombogenic, anticoagulant graft.
  • the coating is stable under standard refrigeration, thereby allowing for an off the shelf composition to be used as needed.
  • the invention provides an anti-thrombogenic vascular graft composition comprising a decellularized blood vessel wherein the luminal surface of the blood vessel is coated with a first layer.
  • the first layer comprises HA.
  • the invention provides an anti-thrombogenic vascular graft composition comprising a decellularized blood vessel wherein the luminal surface of the blood vessel is coated with a multilayer coating.
  • the multilayer coating comprises a first layer comprising HA and a second layer comprising heparin.
  • the HA layer is crosslinked to the luminal surface of the vessel.
  • the heparin layer is crosslinked to the HA layer.
  • one or more layers of the coating comprise a hydrogel.
  • the invention provides a method of making a composition coated with an anti-thrombogenic coating.
  • the method comprises coating a surface of a substrate with a first layer.
  • the substrate is a decellularized tissue.
  • the invention is not limited to any particular type of substrate. Rather, the method encompasses any suitable substrate known in the art, including, but not limited to, native blood vessels, engineered blood vessels, synthetic vascular grafts made from polymers, and blood- contacting catheters made from polymers.
  • the first layer comprises HA. In certain embodiments, the HA is thiol-modified HA.
  • the method comprises using a crosslinker comprising N- hydroxysuccinimide ester (NHS) and maleimide to crosslink the amine groups of the substrate with the sulfhydryl groups of the HA.
  • the method comprises a layer-by-layer coating procedure.
  • the method comprises coating the substrate with a second layer.
  • the second layer is coated atop the first layer.
  • the second layer comprises aminated heparin, which is crosslinked to the HA of the first layer.
  • the invention further provides methods of treatment comprising implanting an anti-thrombogenic composition of the invention.
  • Such methods include implantation of one or more of a biomaterial, tissue engineering substrate, artificial organ, artificial tissue, artificial graft, and the like for treating a disease, disorder, or tissue defect in a subject in need thereof.
  • the method comprises implanting a HA-coated or HA-heparin-coated vascular graft into a subject in need thereof.
  • the coated vascular graft can be used, for example, to treat a subject having a diseased or blocked blood vessel.
  • the coated vascular graft is used in a method of treating an aneurysm.
  • the coated vascular graft is used in a method of bypassing a diseased or blocked vessel. In another embodiment, the coated vascular graft is used in a method of providing vascular access in a subject undergoing or anticipated to undergo hemodialysis.
  • the present invention provides a composition comprising a surface coated with an anti-thrombogenic coating.
  • the composition comprises a biomaterial, tissue engineering substrate, artificial organ, or artificial tissue having at least one surface coated with an anti-thrombogenic coating.
  • the composition of the invention comprises a vascular graft having at least one surface coated with an anti-thrombogenic coating.
  • the vascular graft is a tubular vascular graft having an outer surface, an inner or luminal surface, and a hollow passageway.
  • the tubular vascular grafts of the invention are biocompatible, properly proportioned as to appropriate dimensions such as diameter, length and wall thickness, readily attachable to the intended living tissue such as by sutures, and offer appropriate handling characteristics such as good flexibility, bending and resistance to kinking during bending.
  • the tubular vascular graft of the invention is a conduit through which bodily fluids (e.g., blood) may flow through.
  • the luminal surface of the tubular vascular graft therefore is the inner surface of the graft that, when implanted, is in contact with fluid.
  • These tubular vascular grafts can thus be used to replace segments of native vessels, or otherwise can be used as artificial vessels serving to bypass native vessels.
  • tubular vascular grafts are used as vascular access points.
  • the tubular vascular graft of the invention has mechanical properties substantially similar to native blood vessels. That is, the vascular grafts have the wall strength to withstand the pressure within the vessel.
  • the luminal surface of the tubular vascular graft is coated with a non-thromobogenic coating. The coating prevents platelet adhesion and thrombosis.
  • the tubular vascular graft of the invention has an inner diameter, outer diameter, length, and wall thickness as needed to mimic the native vessel being repaired, replaced, or bypassed.
  • the tubular vascular graft of the invention is a small-caliber vascular graft, having an inner diameter of less than 5cm.
  • tubular vascular graft of the invention as an inner diameter of about [1] mm to about [25] mm.
  • tubular vascular graft of the invention as an outer diameter of about [1] mm to about [25 ] mm.
  • the tubular vascular graft of the invention has a wall thickness of about [100] ⁇ to about [2] mm.
  • the tubular vascular graft of the invention has a length of about [4] cm to about [100] cm.
  • the vascular graft of the invention is a sheet graft.
  • the sheet grafts of the invention can be used, for example, to patch portions of native blood vessels.
  • the sheet graft comprises a luminal surface that, when administered to the native vessel, is in contact with the fluid flowing through the vessel.
  • the luminal surface of the sheet graft is coated with a non- thromobogenic coating.
  • the composition of the invention comprises a substrate, where the surface comprises at least one surface coated with a non- thrombogenic coating.
  • the substrate may be any material or biomaterial known in the art.
  • the substrate is an extracellular matrix protein composition, a collagen-based composition, an elastin-based composition, hydrogel, electrospun scaffold, injection molded polymeric scaffolds, woven and non- woven polymeric scaffolds, metal-based implants, ceramic composite biomaterials, or other tissue engineering substrate.
  • the substrate is decellularized tissue.
  • Decellularized tissue substrates are substrates obtained from harvesting tissue from a donor source and removing cells and cellular debris from the harvested tissue.
  • the decellularized tissue substrates retain the structure of the harvested tissue and can subsequently be used as tissue engineering substrates to be implanted into a subject in need.
  • Methods of producing decellularized tissue substrates are well known in the art. The present invention is not limited to any particular type of decellularized tissue or the manner at which the decellularized tissue was produced.
  • decellularization relies on a chemical methodology.
  • decellularization comprises a chemical methodology combined with mechanical means in order to remove cells from the tissue.
  • the chemical solution or otherwise referred to as the decellularization solution used for decellularization generally includes at least a hypertonic solution, a detergent, and a chelating agent.
  • the hypertonic solution is a hypertonic sodium chloride solution.
  • the detergent is a zwitterionic detergent such as CHAPS.
  • the chelating agent is EDTA.
  • the decellularization solution can include a buffer (e.g., PBS) for osmotic compatibility with the cells.
  • the decellularization solution also can include enzymes such as, without limitation, one or more collagenases, one or more dispases, one or more DNases, or a protease such as trypsin.
  • the decellularization solution also or alternatively can include inhibitors of one or more enzymes (e.g., protease inhibitors, nuclease inhibitors, and/or collegenase inhibitors).
  • a method of producing a decellularized tissue substrate includes perfusing the tissue with the decellularization solution.
  • the pressure for which the decellularization solution is perfused through the tissue can be adjusted to the desired pressure.
  • the decellularization solution is perfused through the tissue at perfusion pressure below about 30 mmHg. In one embodiment, the decellularization solution is perfused through the tissue at pressures less than about 20 mmHg.
  • the decellularized tissue substrate is a decellularized blood vessel.
  • a decellularized blood vessel can serve as a substrate for tubular vascular grafts described elsewhere herein.
  • the decellularization solution can be introduced into blood vessel to effect cell removal.
  • decellularization of blood vessels removes the native endothelium lining of the vessel.
  • the decellularized tissue of the invention consists essentially of the extracellular matrix (ECM) component of all or most regions of the tissue.
  • ECM components can include any or all of the following: fibronectin, fibrillin, laminin, elastin, members of the collagen family (e.g., collagen I, III, and IV), glycosaminoglycans, ground substance, reticular fibers and thrombospondin, which can remain organized as defined structures such as the basal lamina.
  • Successful decellularization is defined as the absence of detectable myofilaments, endothelial cells, smooth muscle cells, epithelial cells, and nuclei in histologic sections using standard histological staining procedures.
  • residual cell debris also has been removed from the decellularized tissue.
  • the decellularization process of a natural tissue preserves the native 3-dimensional structure of the tissue. That is, the morphology and the architecture of the tissue, including ECM components are maintained during and following the process of decellularization.
  • the morphology and architecture of the ECM can be examined visually and/or histologically. For example, the basal lamina on the exterior surface of a solid organ or within the vasculature of an organ or tissue should not be removed or significantly damaged due to decellularization.
  • the fibrils of the ECM should be similar to or significantly unchanged from that of an organ or tissue that has not been decellularized.
  • one or more compounds can be applied in or on a decellularized tissue to, for example, preserve the decellularized tissue, or to prepare the decellularized tissue for recellularization and/or to assist or stimulate cells during the recellularization process.
  • Such compounds include, but are not limited to, one or more growth factors (e.g., VEGF, DKK-1, FGF, BMP-1, BMP-4, SDF-1, IGF, and HGF), immune modulating agents (e.g., cytokines, glucocorticoids, IL2R antagonist, leucotriene antagonists), and/or factors that modify the coagulation cascade (e.g., aspirin, heparin-binding proteins, and heparin).
  • growth factors e.g., VEGF, DKK-1, FGF, BMP-1, BMP-4, SDF-1, IGF, and HGF
  • immune modulating agents e.g., cytokines, glucocorticoids, IL2R antagonist, leu
  • a decellularized organ or tissue can be further treated with, for example, irradiation (e.g., UV, gamma) to reduce or eliminate the presence of any type of microorganism remaining on or in a decellularized tissue.
  • irradiation e.g., UV, gamma
  • Exemplary decellularization methods are used to generate a decellularized tissue provides a controlled, precise way to destroy cells of a tissue, while leaving the underlying ECM, including vascularization, and other gross morphological features of the original tissue intact.
  • the decellularized substrates are then suitable for seeding with appropriate cells.
  • the decellularized substrates are not seeded with cells.
  • the decellularized substrates are coated with a non-thrombogenic coating described elsewhere herein. Where the process is performed in vitro, the decellularized tissue is suitable for implantation into the recipient as a replacement tissue.
  • the present invention includes methods of fabrication of engineered tissues built from such substrates.
  • the tissue is from a relatively large animal or an animal recognized as having a similar anatomy (with regard to the tissue of interest) as a human, such as a pig, a cow, a horse, a monkey, or an ape.
  • the source of the tissue is human, use of which can reduce the possibility of rejection of engineered tissues based on the scaffold.
  • the tissue is engineered in vitro from cells, and then subjected to decellularization.
  • the tissue is a blood vessel obtained from the animal. Any suitable blood vessel may be used to produce the decellularized blood vessel substrate.
  • the composition of the invention comprises at least one surface coated with a non-thrombogenic coating.
  • the non-thrombogenic coating prevents platelet adhesion and activation, thereby reducing thrombosis.
  • the coating prevents access of collagen, or other thrombogenic components that may be present in the substrate, to the blood stream.
  • the coating of the invention is a single layer coating.
  • the coating of the invention is a multi-layer coating.
  • the coating comprises a hydrogel layer.
  • the composition comprises a first layer comprising a hydrogel crosslinked to the substrate. The first layer is sometimes referred to herein as the hydrogel layer.
  • the hydrogel layer comprises thiol-modified hyaluronic acid (HA) or dihydrazide-modified HA or un-modified HA.
  • the hydrogel may comprise any biopolymer or synthetic polymer known in the art.
  • the hydrogel may comprise hyaluronans, chitosans, alginates, collagen, dextran, pectin, carrageenan, polylysine, gelatin or agarose, (see.: W. E. Hennink and C. F. van Nostrum, 2002, Adv. Drug Del. Rev. 54, 13-36 and A. S. Hoffman, 2002, Adv. Drug Del. Rev. 43, 3-12).
  • These materials consist of high- molecular weight backbone chains made of linear or branched polysaccharides or polypeptides.
  • hydrogels based on synthetic polymers include but are not limited to (meth)acrylate-oligolactide-PEO-oligolactide-(meth)acrylate, poly(ethylene glycol) (PEO), poly (propylene glycol) (PPO), PEO-PPO-PEO copolymers
  • Hydrogels can generally absorb a great deal of fluid and, at equilibrium, typically are composed of 60-90% fluid and only 10-30% polymer. In a preferred embodiment, the water content of hydrogel is about 70-80%. Hydrogels are particularly useful due to the inherent biocompatibility of the cross-linked polymeric network (Hill- West, et al., 1994, Proc. Natl. Acad. Sci. USA 91:5967-5971).
  • Hydrogel biocompatibility can be attributed to hydrophilicity and ability to imbibe large amounts of biological fluids (Brannon-Peppas. Preparation and Characterization of Cross-linked Hydrophilic Networks in Absorbent Polymer Technology, Brannon- Peppas and Harland, Eds. 1990, Elsevier: Amsterdam, pp 45-66; Peppas and Mikos. Preparation Methods and Structure of Hydrogels in Hydrogels in Medicine and Pharmacy, Peppas, Ed. 1986, CRC Press: Boca Raton, Fla., pp 1-27).
  • the hydrogels can be prepared by crosslinking hydrophilic biopolymers or synthetic polymers.
  • hydrogels formed from physical or chemical crosslinking of hydrophilic biopolymers include but are not limited to, hyaluronans, chitosans, alginates, collagen, dextran, pectin, carrageenan, polylysine, gelatin or agarose, (see: W. E. Hennink and C. F. van Nostrum, 2002, Adv. Drug Del. Rev. 54, 13-36 and A. S. Hoffman, 2002, Adv. Drug Del. Rev. 43, 3-12). These materials consist of high- molecular weight backbone chains made of linear or branched polysaccharides or polypeptides.
  • hydrogels based on chemical or physical crosslinking synthetic polymers include but are not limited to (meth)acrylate-oligolactide-PEO- oligolactide-(meth)acrylate, poly(ethylene glycol) (PEO), poly(propylene glycol) (PPO), PEO-PPO-PEO copolymers (Pluronics), poly(phosphazene),
  • the transparent hydrogel scaffold comprises poly(ethylene glycol) diacrylate (PEGDA).
  • Hydrogels closely resemble the natural living extracellular matrix (Ratner and Hoffman. Synthetic Hydrogels for Biomedical Applications in Hydrogels for Medical and Related Applications, Andrade, Ed. 1976, American Chemical Society: Washington, D.C., pp 1-36). Hydrogels can also be made degradable in vivo by incorporating PLA, PLGA or PGA polymers. Moreover, hydrogels can be modified with fibronectin, laminin, vitronectin, or, for example, RGD for surface modification, which can promote cell adhesion and proliferation (Heungsoo Shin, 2003, Biomaterials 24:4353-4364; Hwang et al., 2006 Tissue Eng. 12:2695-706).
  • the hydrogel of the invention is crosslinked.
  • Crosslinking of the hydrogel may be performed using any suitable method known in the art.
  • one or more multifunctional cross-linking agents may be utilized as reactive moieties that covalently link biopolymers or synthetic polymers.
  • Such bifunctional cross-linking agents may include glutaraldehyde, epoxides (e.g., bis-oxiranes), oxidized dextran, p-azidobenzoyl hydrazide, N-[a.- maleimidoacetoxyjsuccinimide ester, p-azidophenyl glyoxal monohydrate, bis-[p-(4- azidosalicylamido)ethyl]disulfide, bis[sulfosuccinimidyl]suberate,
  • the hydrogel comprises a photo-activated crosslinking agent.
  • one or more components of the hydrogel is cross-linked upon exposure to UV light.
  • the hydrogel is crosslinked using a heterobifunctional crosslinker comprising NHS and maleimide.
  • the crosslinker links the hydrogel layer directly to the substrate.
  • the NHS reacts with the amine groups on the decellularized vessel substrate
  • the malemide reacts with the sulfhydryl groups on the thiol-modified HA ( Figure 1).
  • the hydrogel is crosslinked using a homobifunctional crosslinker comprising imidoester reactive groups such as the DMA (Dimethyl adipimidate»2 HCl) crosslinker, which is reactive towards amine groups.
  • the crosslinker links the hydrogel layer directly to the substrate.
  • the imidoester reacts with the amine groups on the decellularized vessel substrate, and the amine groups on the dihydrazide-Modified HA.
  • the hydrogel is crosslinked using EDC/NHS crosslinker which crosslinks carboxyl and amine groups.
  • the crosslinker links the hydrogel layer directly to the substrate.
  • the EDC/NHS reacts with the carboxyl groups of the unmodified HA and the amine groups on the decellularized vessel substrate.
  • one or more multifunctional cross-linking agents may be utilized as reactive moieties that covalently link biopolymers or synthetic polymers.
  • Such bifunctional cross-linking agents may include
  • glutaraldehyde epoxides (e.g., bis-oxiranes), oxidized dextran, p-azidobenzoyl hydrazide, N-[a.-maleimidoacetoxy]succinimide ester, p-azidophenyl glyoxal monohydrate, bis-[p-(4-azidosalicylamido)ethyl]disulfide,
  • polyacrylated materials such as ethoxylated (20) trimethylpropane triacrylate
  • ethoxylated (20) trimethylpropane triacrylate may be used as a non-specific photo-activated cross-linking agent.
  • Components of an exemplary reaction mixture would include a thermoreversible hydrogel held at 39°C, polyacrylate monomers, such as ethoxylated (20) trimethylpropane triacrylate, a photo-initiator, such as eosin Y, catalytic agents, such as l-vinyl-2-pyrrolidinone, and triethanolamine.
  • the stabilized cross-linked hydrogel matrix of the present invention may be further stabilized and enhanced through the addition of one or more enhancing agents.
  • enhancing agent or “stabilizing agent” is intended any compound added to the hydrogel matrix, in addition to the high molecular weight components, that enhances the hydrogel matrix by providing further stability or functional advantages.
  • Suitable enhancing agents which are admixed with the high molecular weight components and dispersed within the hydrogel matrix, include many of the additives described earlier in connection with the thermoreversible matrix discussed above.
  • the enhancing agent can include any compound, especially polar compounds, that, when incorporated into the cross-linked hydrogel matrix, enhance the hydrogel matrix by providing further stability or functional advantages.
  • Preferred enhancing agents for use with the stabilized cross-linked hydrogel matrix include polar amino acids, amino acid analogues, amino acid derivatives, intact collagen, and divalent cation chelators, such as
  • EDTA ethylenediaminetetraacetic acid
  • Polar amino acids are intended to include tyrosine, cysteine, serine, threonine, asparagine, glutamine, aspartic acid, glutamic acid, arginine, lysine, and histidine.
  • the preferred polar amino acids are L-cysteine, L-glutamic acid, L-lysine, and L-arginine. Suitable
  • concentrations of each particular preferred enhancing agent are the same as noted above in connection with the thermoreversible hydrogel matrix.
  • Polar amino acids, EDTA, and mixtures thereof, are preferred enhancing agents.
  • the gels can be loaded with growth factors: basic fibroblast, growth factor (bFGF) and/or vascular endothelial growth factor (VEGF), VEGF or bFGF is incorporated to the hyaluronic acid gel prior to the addition of the crosslinker. Crosslinking then proceeds with no other modifications entrapping the growth factors within the hyaluronic acid gels.
  • the growth factors may be added at a concentration of 50 ng/cm 3 area of vessel to be cross-linked.
  • the enhancing agents can also be added to the matrix composition during the crosslinking of the high molecular weight components.
  • the enhancing agents are particularly important in the stabilized cross- linked bioactive hydrogel matrix because of the inherent properties they promote within the matrix.
  • the hydrogel matrix exhibits an intrinsic bioactivity that will become more evident through the additional embodiments described hereinafter. It is believed the intrinsic bioactivity is a function of the unique stereochemistry of the cross-linked macromolecules in the presence of the enhancing and strengthening polar amino acids, as well as other enhancing agents.
  • the hydrogel layer may comprise one or more therapeutic agents.
  • one or more therapeutic agents can be embedded within the hydrogel layer.
  • the hydrogel layer can be modified with functional groups for covalently attaching a variety of proteins (e.g., collagen) or compounds such as therapeutic agents.
  • Therapeutic agents include, but are not limited to, analgesics, anesthetics, antifungals, antibiotics, anti-inflammatories, anthelmintics, antidotes, antiemetics, antihistamines, antihypertensives, antimalarials, antimicrobials, antipsychotics, antipyretics, antiseptics, antiarthritics, antituberculotics, antitussives, antivirals, cardioactive drugs, cathartics, chemotherapeutic agents, a colored or fluorescent imaging agent, corticoids (such as steroids), antidepressants, depressants, diagnostic aids, diuretics, enzymes, expectorants, hormones, hypnotics, minerals, nutritional supplements, parasympathomimetics, potassium supplements, radiation sensitizers, a radioisotope, sedatives, sulfonamides, stimulants, sympathomimetics, tranquilizers, urinary anti-infectives, vasoconstrictors, vasod
  • the therapeutic agent can also be other small organic molecules, naturally isolated entities or their analogs, organometallic agents, chelated metals or metal salts, peptide-based drugs, or peptidic or non-peptidic receptor targeting or binding agents, or pep tide/protein growth factors or cytokines. It is contemplated that linkage of the therapeutic agent to the matrix can be via a protease sensitive linker or other biodegradable linkage.
  • Molecules which can be incorporated into the hydrogel matrix include, but are not limited to, vitamins and other nutritional supplements; glycoproteins (e.g., collagen); fibronectin; peptides and proteins;
  • oligonucleotides sense and/or antisense DNA and/or RNA
  • antibodies for example, to infectious agents, tumors, drugs or hormones
  • gene therapy reagents for example, to a patient's disease, diabetes, neurological disorders, neurological disorders, neurological disorders, neurological disorders, neurological disorders, neurological disorders, neurological disorders, neurological disorders, neurological disorders, neurological disorders, neurological disorders, neurological disorders, neurological disorders, neurological disorders, neurological disorders, neurological disorders, neurological disorders, neurological disorders, and/or RNA
  • antibodies for example, to infectious agents, tumors, drugs or hormones
  • gene therapy reagents for example, to infectious agents, tumors, drugs or hormones
  • the hydrogel layer, coated along the luminal surface of the substrate has a thickness of about [100] nm to about [3] mm.
  • the hydrogel layer is coated with a second layer.
  • the hydrogel layer is coated with a second layer comprising an anticoagulant.
  • the second layer comprises heparin or derivatives thereof.
  • the present invention is not limited to the use of heparin as an anti-coagulant. Rather, any known anti-coagulant may be used.
  • anticoagulants include, but are not limited to vitamin K antagonists, coumarins, Curcumin (diferuloyl methane), Hirudin, heparins, Factor Xa inhibitors, direct Xa inhibitors, direct thrombin inhibitors, natural polysaccharides and synthetic ones based on ⁇ -(1- 4)linked anhydroglucose units, chondroitin sulfate, glycosaminoglycans, and the like.
  • the second layer is crosslinked to the first layer.
  • the anti-coagulant of the second layer is crosslinked to the hyaluronic acid of the first layer (e.g., hydrogel layer).
  • the anti-coagulant of the second layer is modified, which in certain instances allows for easier crosslinking to the first layer.
  • the second layer comprises aminated heparin, wherein the heparin comprises a primary amine group.
  • the heparin is aminated at the end-chain electrophilic carbon atom ("end-on animation") ( Figure 2).
  • the aminated heparin is crosslinked to the hyaluronic acid via EDC/NHS.
  • the composition of the invention is not limited to any particular crosslinker. Rather any type or crosslinker known in the art that is suitable to crosslink one or more components of the first layer to one or more components of the second layer may be used.
  • the aminated heparin of the second layer is crosslinked to the carboxyl groups of the HA of the first layer.
  • the aminated heparin is crosslinked to thiol groups of the HA of the first layer.
  • the aminated heparin is further modified to contain NHS and a sulfhydryl-reactive malemide group. This modified heparin can then spontaneously react with the remaining thiol groups of the thiol-modified HA of the first layer ( Figure 2).
  • the heparin of the second layer extends luminally, thereby exposing the active pentasaccharide sequence of heparin to the blood stream when the composition is implanted. This conformation thereby prevents immediate activation of coagulation.
  • the coating of the anti-thrombogenic compositions of the invention is biocompatible and non-toxic. For example, it is demonstrated elsewhere herein that cells contacted to the coating can survive and proliferate. Thus, while in certain embodiments, the compositions of the invention are not recellularized prior to implantation in a subject, the compositions are conducive to in vivo recellularization of native cells. In certain embodiments, the in vivo recellularization degrades the coating over time.
  • the coating of the anti-thrombogenic compositions of the invention is non-immunogenic. That is, the coating does not induce an immune response in the subject.
  • the present invention provides a method of making compositions having at least one surface coated with a non-thrombogenic coating.
  • the composition of the invention comprises a substrate, for example a biomaterial, tissue engineering substrate, or the like, wherein at least one surface of the substrate is coated with a non-thrombogenic coating.
  • the substrate comprises decellularized tissue.
  • the present invention is not limited to any particular decellularized tissue, nor is it limited to any particular method of generating decellularized tissue. Exemplary methods of producing decellularized tissue are discussed elsewhere herein and are well known in the art, see for example US2012/0064050 and WO2007/025233, each of which are herein incorporated by reference in their entireties.
  • the method comprises coating a surface of the substrate with the non- thrombogenic coating.
  • the coating in certain embodiments comprises a single layer or a multi-layer coating.
  • the method comprises perfusing the substrate with one or more solutions.
  • the decellularized tissue substrate is perfused with water, saline, or the like, prior to application of the non-thromobogenic coating.
  • the composition of the invention comprises a hydrogel layer crosslinked to a
  • the decellularized tissue substrate is perfused with a crosslinking containing solution.
  • the present invention is not limited to any particular type of crosslinker. Rather, any suitable crosslinker known in the art may be employed.
  • the crosslinker is SM(PEG)n NHS-
  • the crosslinker is dissolved in DMSO and PBS to form a crosslinking solution.
  • the relative amount of the crosslinker in the crosslinking solution may be varied as appropriate.
  • the concentration of the crosslinker in the crosslinking solution is about 0.1 mM to about 500mM.
  • the concentration of the crosslinker in the crosslinking solution is about ImM to about lOOmM.
  • the concentration of the crosslinker in the crosslinking solution is about 40mM.
  • the crosslinker solution may be then perfused onto the decellularized tissue substrate. As discussed elsewhere herein, in certain embodiments the substrate is a decellularized blood vessel.
  • the tubular decellularized vessel is continuously perfused with the solution through the lumen of the vessel.
  • the solution is perfused in a closed loop fashion.
  • the substrate is perfused with the crosslinking solution for about 5 seconds to about 2 hours.
  • the substrate is perfused with the crosslinking solution for about 30 seconds to about 24 hours.
  • the substrate is perfused with the crosslinking solution for about 30 minutes.
  • the substrate is perfused with a hydrogel solution.
  • the hydrogel solution may comprise any suitable biopolymer, synthetic polymer, or combination thereof.
  • the hydrogel solution comprises HA.
  • the hydrogel solution comprises thiol-modified HA.
  • the hydrogel solution may be produced by dissolving the thiol-modified HA into water or other suitable solvent.
  • the solvent is degassed, as in certain instances, the HA will crosslink in the presence of oxygen.
  • the tubular decellularized vessel is continuously perfused with the hydrogel solution through the lumen of the vessel. In one embodiment, the solution is perfused in a closed loop fashion.
  • the substrate is perfused with the hydrogel solution for about 5 seconds to about 8 hours. In another embodiment, the substrate is perfused with the hydrogel solution for about 30 seconds to about 4 hours. In another embodiment, the substrate is perfused with the crosslinking solution for about 2 hours. After perfusion of the hydrogel solution, in certain embodiments, the substrate is rinsed with water, saline, or the like. In certain embodiments, in order to produce a rough morphology of the luminal surface, the substrate is perfused with a solution comprising hylaronidase and collagenase.
  • the substrate is coated with a second layer comprising an anti-coagulant.
  • the second layer comprises heparin or derivatives thereof.
  • the present invention is not limited to the use of heparin as an anti-coagulant. Rather, any known anti-coagulant may be used.
  • Exemplary anti-coagulants include, but are not limited to vitamin K antagonists, coumarins, curcumin (diferuloyl methane), hirudin, heparins, Factor Xa inhibitors, direct Xa inhibitors, direct thrombin inhibitors, natural polysaccharides and synthetic ones based on ⁇ -(1-> )- linked anhydroglucose units and the like.
  • the heparin is modified.
  • ADH-amino modified heparin is prepared by dissolving heparin into a suitable solvent, for example, formamide, and adding adipic acid dihyrazide (ADH).
  • ADH adipic acid dihyrazide
  • aqueous sodium cyanoborohydride is added to the mixture.
  • the mixture is then dialyzed.
  • the retentate may then be lyophilized and purified, for example, by ethanol precipitation.
  • coating of the substrate with the second layer comprises first perfusing the substrate with a second crosslinking solution.
  • the method comprises perfusing a second crosslinking solution comprising EDC and NHS.
  • the second crosslinking solution comprises water, saline, or other suitable buffer.
  • the second crosslinking solution comprises NaCl/MES buffer.
  • the EDC/NHS of the second crosslinking solution allows for crosslinking of the second layer to the carboxyl groups of the HA of the first layer.
  • the substrate is perfused with the second crosslinking solution for about 5 seconds to about 2 hours.
  • the substrate is perfused with the second crosslinking solution for about 30 seconds to about 1 hour.
  • the substrate is perfused with the second crosslinking solution for about 15 minutes.
  • coating of the substrate with the second layer comprises first activating with a crosslinking solution the heparin (or any known anticoagulant) before perfusion on the substrate.
  • the method comprises the addition of hetero-bifunctional crosslinkers such as Sulfo- SMCC activating the aminated heparin. This allows the pre-activated amine groups of heparin to crosslink spontaniouslly on accessible thiol groups on the first layer.
  • the heparin (or any known anti-coagulant) carboxyl groups are activated via a crosslinking solution comprising EDC and NHS.
  • the substrate is perfused with the second crosslinking solution for about 5 seconds to about 2 hours.
  • the substrate is perfused with the second crosslinking solution for about 30 seconds to about 1 hour.
  • the substrate is perfused with the second crosslinking solution for about 15 minutes.
  • coating of the substrate with the second layer comprises perfusing the substrate with an anti-coagulant solution.
  • the anti-coagulant solution comprises a heparin solution.
  • the heparin solution comprises heparin dissolved in a suitable solvent, including, but not limited to, water, saline, or other buffer.
  • heparin is dissolved in NaCl/MES buffer.
  • the heparin of the heparin solution is modified.
  • the amount of heparin in the heparin solution may be varied as necessary.
  • the amount of heparin may, in certain instances, depend on the ultimate use of the composition.
  • the concentration of heparin in the heparin solution is [5 ⁇ ].
  • the substrate is perfused with the heparin solution for about 5 seconds to about 3 hours.
  • the substrate is perfused with the heparin solution for about 30 seconds to about 2 hours.
  • the substrate is perfused with the second crosslinking solution for about 1 hour.
  • the substrate is rinsed with water, saline, or other suitable buffer following perfusion of the heparin solution.
  • the method comprises ex vivo or in vitro culturing of cells on the surface of the substrate, or on the coating of the substrate.
  • the cultured cells can be induced to proliferate throughout at least a portion of the composition.
  • cells are cultured such that they produce a confluent layer of cells on the luminal surface of a vascular graft composition described herein.
  • the cells can also differentiate in vitro by culturing the cells in differentiation.
  • the cells can differentiate in vivo when they establish contact with a tissue within the mammal or when the cells are sufficiently close to a tissue to be influenced by substances (e.g., growth factors, enzymes, or hormones) released from the tissue.
  • substances e.g., growth factors, enzymes, or hormones
  • the substrate of the composition is decellularized tissue. Therefore, in certain embodiments, the method comprises recellularization of the substrate. The number of cells that is introduced into and onto a decellularized organ in order to generate an organ or tissue is dependent on both the organ (e.g., which organ, the size and weight of the organ) or tissue and the type and
  • a decellularized organ or tissue can be seeded with at least about 1,000 (e.g., at least 10,000, 100,000, 1,000,000, 10,000,000, or 100,000,000) regenerative cells; or can have from about 1,000 cells/mg tissue (wet weight, i.e., prior to decellularization) to about 10,000,000 cells/mg tissue (wet weight) attached thereto.
  • Cells can be introduced to a decellularized organ or tissue by injection into one or more locations.
  • more than one type of cell i.e., a cocktail of cells
  • a cocktail of cells can be injected at multiple positions in a decellularized organ or tissue or different cell types can be injected into different portions of a decellularized organ or tissue.
  • regenerative cells or a cocktail of cells can be introduced by perfusion into a cannulated decellularized organ or tissue.
  • cells can be perfused into a decellularized organ using a perfusion medium, which can then be changed to an expansion and/or differentiation medium to induce growth and/or differentiation of the regenerative cells.
  • the cells can be introducted into either or both of the airway compartment via the trachea, or the vascular compartment via the pulmonary artery or vein.
  • an organ or tissue is maintained under conditions in which at least some of the regenerative cells can multiply and/or differentiate within and on the decellularized organ or tissue.
  • Those conditions include, without limitation, the appropriate temperature and/or pressure, electrical and/or mechanical activity, force, the appropriate amounts of (3 ⁇ 4 and/or CO 2 , an appropriate amount of humidity, and sterile or near-sterile conditions.
  • the decellularized organ or tissue and the cells attached thereto are maintained in a suitable environment.
  • the cells may require a nutritional supplement (e.g., nutrients and/or a carbon source such as glucose), exogenous hormones or growth factors, and/or a particular pH.
  • Cells can be allogeneic to a decellularized organ or tissue (e.g., a human decellularized organ or tissue seeded with human cells), or regenerative cells can be xenogeneic to a decellularized organ or tissue (e.g., a pig decellularized organ or tissue seeded with human cells).
  • a decellularized organ or tissue e.g., a human decellularized organ or tissue seeded with human cells
  • regenerative cells can be xenogeneic to a decellularized organ or tissue (e.g., a pig decellularized organ or tissue seeded with human cells).
  • an organ or tissue generated by the methods described herein is to be transplanted into a patient.
  • the cells used to recellularize a decellularized organ or tissue can be obtained from the patient such that the regenerative cells are autologous to the patient.
  • Cells from a patient can be obtained from, for example, blood, bone marrow, tissues, or organs at different stages of life (e.g., prenatally, neonatally or perinatally, during adolescence, or as an adult) using methods known in the art.
  • cells used to recellularize a decellularized organ or tissue can be syngeneic (i.e., from an identical twin) to the patient, cells can be human lymphocyte antigen (HLA)-matched cells from, for example, a relative of the patient or an HLA-matched individual unrelated to the patient, or cells can be allogeneic to the patient from, for example, a non-HLA- matched donor.
  • HLA human lymphocyte antigen
  • the decellularized solid organ can be autologous, allogeneic or xenogeneic to a patient.
  • a decellularized tissue may be recellularized with cells in vivo (e.g., after the tissue has been transplanted into an individual).
  • In vivo recellularization may be performed as described above (e.g., injection and/or perfusion) with, for example, any of the cells described herein.
  • in vivo seeding of a decellularized organ or tissue with endogenous cells may occur naturally or be mediated by factors delivered to the recellularized tissue.
  • the present invention provides therapeutic methods comprising the administration or implantation of the anti-thrombogenic compositions (e.g., anti- thrombogenic vascular grafts) described herein.
  • the anti-thrombogenic vascular grafts of the invention are used in methods to replace or bypass damaged or diseased blood vessels in a subject.
  • the methods are used to treat an aneurysm in a subject.
  • the methods are used to replace or bypass vessels which provide inadequate blood flow.
  • the method comprises treating a subject having a diseased blood vessel.
  • exemplary diseases or disorders treated by way of the present method include, but are not limited to, peripheral vascular disease, atherosclerosis, aneurysm, or venous thrombosis.
  • the subject is a mammal. In one embodiment, the subject is a human.
  • Grafting of the substrates and compositions of the invention to an organ or tissue to be augmented can be performed according to the methods described in herein or according to art-recognized methods.
  • the composition can be grafted to an organ or tissue of the subject by suturing the graft material to the target organ.
  • Implanting a neo-organ construct for total organ replacement can be performed according to the methods described herein or according to art-recognized surgical methods.
  • vascular grafts of the invention are sutured to existing blood vessels of the subject.
  • an anti-thrombogenic vascular graft described herein may be sized and shaped appropriately to mimic or replace a particular damaged or abnormal blood vessel of the subject.
  • the region of native blood vessel to be replaced is surgically excised from the subject. The ends of the vascular graft of the invention can then be sutured to the remaining vessel.
  • vascular grafts of this invention may be used in place of any current by-pass or shunting graft, either natural or artificial, in any application. Thus, they may be used for, without limitation, arterial by-pass, both of the cardiac variety and that used to treat peripheral vascular disease (PVD).
  • PVD peripheral vascular disease
  • a graft of this invention may also be used as a replacement or substitute for a fistula created for use in
  • vascular graft of the present invention can be used to replace a damaged blood vessel such as traumatically damaged limb arteries.
  • the method of the invention comprises implantation of the graft of the invention to provide an artificial arteriovenous shunt or graft for use by dialysis patients.
  • a patient's blood is "cleansed" by passing it through a dialyzer, which consists of two chambers separated by a thin membrane. Blood passes through the chamber on one side of the membrane and dialysis fluid circulates on the other. Waste materials in the blood pass through the membrane into the dialysis fluid, which is discarded, and the "clean" blood is recirculated into the blood stream.
  • Access to the bloodstream can be external or internal. External access involves two catheters, one placed in an artery and one in a vein. More frequently, and preferably, internal access is provided.
  • An artriovenous fistula involves the surgical joining of an artery and a vein under the skin.
  • the increased blood volume stretches the elastic vein to allow for a larger volume of blood flow. Needles are placed in the fistula so that blood can be withdrawn for dialysis and then the blood is returned through the dilated vein.
  • An AV graft may be used for people whose veins, for one reason or another, are unsuitable for an AV fistula.
  • An AV graft involves surgically grafting a donor vein from the patient's own saphenous vein, a carotid artery from a cow or a synthetic graft from an artery to a vein of the patient.
  • One of the major complications with a synthetic AV graft is thrombosis and neointimal cell proliferation that cause closure of the graft.
  • vascular grafts of the invention are non-thrombogenic without the need seeding of the graft with the subject or donor cells.
  • the grafts can be implanted at the time that it becomes necessary. That is, there is no waiting time needed in order to prepare the grafts.
  • the grafts of the invention are stable during standard refrigeration, and thus can serve as an off the shelf composition.
  • Example 1 Hyaluronic acid - heparin based coatings for biological substrates
  • HA thiol- modified hyaluronic acid
  • Thiol-modified HA (Glycosan, San Francisco, USA) was crosslinked onto decellularized biological structures amines groups (NH 2 ) using the sulfhydryl (SH) groups on the HA. This was accomplished via heterobifunctional crosslinker made up of N-hydroxysuccinimide ester (NHS) and maleimide where NHS reacts with the amine groups on the decellularized vessels and maleimide reacted with the sulfhydryl groups on the hyaluronic acid.
  • NHS N-hydroxysuccinimide ester
  • maleimide maleimide
  • the crosslinked hyaluronic acid created a few microns thick continuous layer over the length of the tubular vessel, "hiding" the exposed collagen of decellularized vessels.
  • the second step of the coating was the "end on” aminated heparin, produced via reductive amination, which was crosslinked onto the carboxyl (COOH) groups of the hyaluronic acid via EDC/NHS.
  • the "end-on" heparin amination was accomplished on the heparin end-chain electrophilic carbon atom, which under heat attacked the nucleophilic nitrogen of adipic acid dihydrazide (ADH) primary amine to yield a weak bond stabilized using sodium cyanoborohydride (NaCNBHs). This yielded an end-on primary amine group on the heparin ( Figure 2 A Top).
  • heparin modification comprises an additional step.
  • the heparin modification can be taken further by modifying the ADH primary amine with Sulfosuccinimidyl-4-(N-maleimidomethyl)cyclohexane- 1-carboxylate (Sulfo- SMCC) ( Figure 2A Bottom). This route used the ADH-amine to link NHS leaving a sulfhydryl-reactive maleimide group. The modified heparin was spontaneously reactive with the remaining thiol groups on the hyaluronic coatings.
  • Sprague Dawley rats ascending aorta was harvested under general anesthesia (isoflorane). Briefly, the rats were opened by a midline laparotomy and the ascending aorta was dissected free. The aorta was then rinsed with cold PBS and was subjected to decellularization within half an hour of isolation.
  • Tissue-engineered porcine arteries were created by seeding five million porcine carotid smooth muscle cells onto a tubular polyglycolic acid mesh (3 mm in diameter and 8 mm in length; Concordia Medical, Coventry, RI) around a silicone tube and cultured in a bioreactor connected to a peristaltic pump at 5% CO 2 and 37 °C.
  • the engineered vessels were harvested from bioreactors after 8 weeks of culture and rinsed two to three times with PBS to remove traces of culture medium. Within half an hour of isolation, tissues were subjected to decellularization.
  • Decellularization was accomplished using a detergent-based method that included incubation in CHAPS/SDS buffer (8 mM CHAPS, 1 M NaCl, and 25 mM ethylenediaminetetraacetic acid (EDTA), 1.8 mM SDS, 1 M NaCl, in PBS) for 24 hours, followed by a 2-day wash with PBS to completely remove the detergent. Finally, aortas and/or tissue engineered grafts were incubated in PBS containing 10% (v/v) FBS (Hyclone, Logan, UT) and 1% Penicillin/ Streptomycin (Pen/Strep). All decellularization steps were carried out at 37°C with agitation under sterile conditions. Decellularized vessels were stored in PBS containing 1% Pen/Strep at 4°C for up to 2 weeks.
  • CHAPS/SDS buffer 8 mM CHAPS, 1 M NaCl, and 25 mM ethylenediaminetetraacetic acid (EDTA), 1.8
  • the decellularized vessels were mounted on in-house built closed loop perfusion chamber via end-ligation of the vessels onto capped needles. Before coating the vessels, they were perfused with 5% Pen/Strep in PBS solution.
  • the crosslinker solution was perfused back inside the vessel via a second loop, creating a continuous perfusion in a loop fashion for 30 min.
  • the excess crosslinker was rinsed out of the vessel by open-end perfusion of the vessels with 100 ml of PBS. Rinsing was not done for more than 15 min as the thiol-reactive groups of the attached crosslinker reacted with the water in PBS.
  • the thiol-modified hyaluronic acid (Glycosan, San Francisco, USA) was then dissolved in 1 ml of degased water without uncapping the vial. The vial was placed on rotating plate for 30 minutes to fully dissolve.
  • Two milliliters of the reconstituted thiol-modified hyaluronic acid were perfused into the vessel over the course of 2 hours in a closed loop fashion. After 2 hours, the excess thiol-modified hyaluronic acid was removed by syringe aspiration inserted into the 3-way stopcock. The vessel was then rinsed for 2 hours with 500 ml of PBS in a one loop fashion removing unreacted but bound hyaluronic acid.
  • cleaned vessels were perfused with 5 ml of Hylaronidase (300 ⁇ g/ml)/ collagenase (0.5 mg/ml) mixture at 37°C for 2 hr. After perfusion of the Hylaronidase/collagenase mixture, the vessels were rinsed with 200 ml of PBS via open-end perfusion.
  • ADH-amino modified heparin was prepared by adding heparin (100 mg, 8.3 ⁇ ) into 10 mL of formamide and heating at 50°C. After heparin was totally dissolved (about 30 mins), adipic acid dihydrazide (ADH) (lOmg, 92 ⁇ ) was added. The reaction was maintained at 50°C for 6 h. Aqueous sodium
  • MWCO molecular weight cutoff
  • the crosslinking of HA onto decellularized aortas using the aortas amine groups and HA thiol groups via NHS-maleimide SM(PEG)i2 crosslinker was optimized to 40mM SM(PEG) i2 crosslinker concentration for a full coverage of the decellularized structures.
  • the surface accessible carboxyl groups available on the HA layer for the heparin addition step was assessed via nanoparticles (NPs) tagging. As indicated by the NPs at 40 mM SM(PEG) i2 concentration, an abundance of free carboxyl groups remain on the surface of the HA coating.
  • Tubular decellularized rat abdominal aortas were coated in a closed loop perfusion.
  • the morphological changes in the vessel luminal side were obvious in scanning electron microscopy (SEM) images, as shown in Figure 4.
  • SEM scanning electron microscopy
  • the control- decellularized aortas luminal diameter about 3mm
  • a SEM cross-section of the decellularized rat abdominal aortas layer- by-layer HA-heparin coating showed that the coating extending luminally in the aorta. As shown in Figure 5, the coating was observed as a smoothed structure coating the porous vessel.
  • Toluidine Blue is a basic dye attracted to negatively charged structures such as heparin.
  • Alcian Blue and Alcian blue/PAS cationic dyes are also attracted to negatively charged structures under alkaline conditions. As shown in Figure 6, all three dyes stained the HA-heparin coating strongly.
  • the Factor X assay was utilized. It was a method based on the conformational change of antithrombin III by bioactive heparin, resulting in factor Xa inhibition. The Factor X inhibition was then measured by S-2732 Chromogenic substrate (Suc-Ile- Glu(g-Pip)-Gly-Arg-pNA), and functional heparin was assessed by comparison with Heparin standards (0-100 ng) reacted in the same manner as the scaffolds. The capacity of a surface to inactivate Factor X was strongly correlated with the surface capacity to delay the blood coagulation cascade.
  • the HA-heparin coated decellularized aortas showed at least as much active heparin, which inhibits Factor X activity (Figure 9).
  • Decellularized control aortas were highly thrombogenic and did not demonstrate any heparin activity, as demonstrated by very low Factor X inactivation (see Figure 9).
  • human umbilical vein endothelial cells isolated from human umbilical cord were seeded onto the HA-heparin layer-by-layer coated aortas and cultured for 2 weeks.
  • the HUVECs proliferated over the coating surface but also invaded the coating by degrading it over the course of the two weeks.
  • the HUVECs downward invasion into the coating could be seen from the confocal microscopy image ( Figure 10), where inward migrating HUVECs were shown over a ⁇ z-stack.
  • the data described herein demonstrated HA and HA-heparin coatings served as anti-thrombogenic coatings for biological scaffolds including decellularized vascular grafts.
  • the coating described herein utilized the crosslinking of HA to protein substrates of the decellularized tissue.
  • the layer-by-layer coating of heparin on HA enhanced the immediate anti-coagulant properties.
  • the HA layer offered a physical barrier to thrombogenic collagen, other extracellular matrix proteins, or synthetic materials which stimulated the extrinsic or intrinsic coagulation cascade, while the layer of active heparin was attached in its active conformation with an exposed pentasaccharide sequence free to interact with blood components.
  • HA coatings may be efficacious for small caliber grafts (i.e., less than or equal to 6 mm in diameter). Further, HA-coated grafts displayed higher mechanical properties as measured by increased suture strengths that were conferred by the mechanical characteristics of the coating. The data also demonstrated that HA-coatings and HA-heparin layer-by-layer coatings were highly conducive to cellular ingrowth. Therefore, as presented herein, HA coatings and layer-by-layer HA-heparin coatings served as functional anti-thrombotic coatings of vascular grafts.
  • the time of gelation of the PEG crosslinker and hyaluronic acid (HA) was evaluated at 25 °C via a strain-controlled rheometer (ARES LSI, TA Instruments, New Castle, DE).
  • a porcine decellularized aorta was mounted onto the titanium cone of the apparatus, followed by the incubation of 400 ⁇ of PEG crosslinker for 45 mins. After this, the PEG crosslinker was aspirated, and 1000 ⁇ of HA was loaded on top of the decellularized porcine aorta (these steps mimicked the 3D perfused coating).
  • the decellularized porcine aorta- HA gel complex was closed with the stainless plate of the apparatus (25-mm diameter, 0.04-radian angle, 45- ⁇ gap).
  • the HA gels were deposited onto decellularized porcine aorta without the addition of the PEG crosslinker step, and the system was closed with the stainless plate in the same way.
  • Elastic (G') and loss (G") moduli 1% strain, 1 Hz) were recorded every 9 s for 24 h.
  • the complex shear modulus (storage modulus) G of the HA-PEG gels and HA gels alone was calculated from:
  • T was the torque response
  • d was the sample diameter
  • ⁇ was the sinusoidal shear strain
  • the rheological response to imposed oscillatory shear stress of the HA gels on the decellularized aorta in the absence of the crosslinker was a fluid-like initial response that polymerized to 80% of the added volume after 23 hours. This was shown in panel A and the 23 hours were indicated by the red dotted line intersecting the x-axis of log time at 5 x 10 4 sec.
  • the rheological characterization thereby described set the perfusion time of the HA component onto the decellularized vessels to create the coating to a minimum perfusion time of 4 hours to a maximum perfusion time of 18 hours.
  • porcine and rat aorta as well as tissue engineered vascular grafts, were decellularized and coated both with
  • Hyaluronic acid alone and Hyaluronic acid / Heparin (HA/HP) .
  • the example shown here was from rat decellularized abdominal aortas but the various studied vasculature structures behaved similarly.
  • the stability of HA and HA/HP coatings was evaluated at 37°C over two weeks by incubating the coated decellularized vessels under the following conditions: 1) PBS; 2) M199 cell culture medium; and 3) freshly isolated rat blood plasma obtained by filtering freshly drawn rat blood through 0.2 ⁇ syringe filters. Following the above described incubations, the eluted coating was assessed by quantifying the total amount of polysaccharides in solution at Day 1, 3, 7 and 14 using the Carbazole assay. The Carbazole assay quantifies polysaccharides in solution based on colorimetric changes with a detection limit of 2 ⁇ g/ml.
  • the amount of released HA and HA/HP from the various coated decellularized surfaces was comparable to the amount of polysaccharides released from the uncoated decellularized vessels (stable negative control samples). For instance the highest amounts of detected released polysaccharides from the coated surfaces was of 0.2 ug/ml which was the amount of polysaccharides released by the non-coated decellularized vessel used as negative control and it also was below the Carbazole assay detection limit. The low polysaccharides released into solution over time indicated high stability of the coating under in vitro physiological conditions.
  • the coated decellularized grafts were histologically assessed for remaining coating on the decellularized vessels using Toluidine Blue, and Alican Blue/PAS dyes.
  • Toluidine Blue and Alican Blue/PAS dyes.
  • the Hyaluronic acid/ Heparin coated decellularized rat aortas kept a continuous layer of the coating in place. This was especially evident in comparison with the uncoated (control) decellularized rat aortas where only the background stain of the decellularized aorta was present.
  • the endothelial cell growth response on the individual coating layers was evaluated.
  • a PEG crosslinker layer alone, PEG crosslinker and Hyaluronic acid layer, and lastly the PEG crosslinker- Hyaluronic acid and heparin components combined were coated.
  • each of these systems was seeded with freshly isolated human umbilical vein endothelial cells (HUVECs) and cultured for three days.
  • Figure 13 shows the day 3 cultured HUVECs that were stained with DAPI for nuclei ( Figure 13), and VE-Cadherin for an endothelial membrane surface marker (Figure 13). It was seen that the various layers of the coating supported endothelial cell adhesion and proliferation in vitro.
  • Rat aortas from the thoracic and abdominal portion were harvested and decellularized.
  • the decellularized rat aortas were implanted in three rats without further modification (control group) and three decellularized rat aortas were
  • Hyaluronic Acid coated prior to implantation using the steps of applying the PEG crosslinker followed by thiolated HA to form a gel on the luminal surface of the decellularized aortas.
  • the rat implantation was done by first clamping the proximal and distal portions of the infrarenal aorta and removing a 17 -mm segment of aorta that was replaced by decellularized rat aorta untreated (control group) or Hyaluronic Acid- coated decellularized rat aorta.
  • the grafts were inserted by end-to-end anastomosis using interrupted 9-0 monofilament nylon sutures.
  • hematoxylin and eosin H&E
  • Uncoated decellularized grafts (control groups) shown in Figure 14 top panel formed large clots with large amounts of fibrin deposition that almost fully occluded the blood flow of the abdominal aorta.
  • the H&E staining was showing the large fibrinized blood clot that was covering almost the entire luminal opening of the implanted graft.
  • the Doppler ultrasound recording of the blood flow at four weeks post-implantation was showing no recording of the blood flow. In some rats there was total absence of blood flow and in other there was some minimal blood flow of about 3 cm/s.
  • the Hyularonic acid coated decellularized rat aorta demonstrated absence of blood clots in most rats as was shown in the H&E stained cross section of the bottom panel in Figure 13.
  • Some rats showed small to medium sized clots deposition and some occlusion of the implanted aorta.
  • the Hyaluronic acid coating was visible in the explants on some areas of the lumen (shown in Figure 14 bottom panel) but the thickness of the coating was greatly reduced.
  • the Hyaluronic acid coated decellularized rat aortas demonstrated normal blood flow at the time of explantation of 4 weeks as was shown in Figure 15 bottom panel.
  • the explants were not dilated and resembled in appearance as pre-implantation. On most areas, the implants were abluminally integrated within the surrounding tissues. Staining for T- cells and macrophage markers has revealed no conclusive signs of inflammation reactions in the implants.
  • Hyaluronic acid coated decellularized vascular rat aortas implanted in the rat animal model suggested clinical feasibility of hyaluronic acid coated vascular grafts.
  • Tissue engineered vascular grafts were grown as per established protocols starting with dog harvested smooth muscle cells. Grafts were 4 mm diameter and approximately 5 cm in length. TEVG were decellularized as described previously in patent. In the control group, the decellularized TEVG were implanted without further modifications; and the second animal group received Hyaluronic acid and heparin-coated decellularized TEVG. The dog study used longer grafts than the rat animal study (implanted grafts were about 5 cm in length), and the implantation site of carotid artery was chosen as a more aggressive animal model than the rat abdominal aorta.
  • the implantation surgery was performed by first identifying and dissecting the dog carotid arteries free from surrounding tissue. One centimeter of the carotid artery was removed and a Hyaluronic acid-heparin-coated decellularized TEVG (4-mm internal diameter) was implanted into the right carotid artery using end to side anastomoses. The non-coated decellularized TEVG (4-mm internal diameter) was implanted in the left carotid artery by the same procedure. The internal diameter of the vascular grafts closely matched with the recipient carotid arteries. The patency of all vascular grafts was checked by Doppler ultrasound immediately after implantation. The implants were kept in the dogs for four weeks, at which time they were explanted and histologically examined.
  • decellularized TEVG demonstrated variable results, with some areas showing total absence of blood clots and other areas showing some blood clot formation, but significantly less than the control grafts. Endothelial cells were found on the luminal surface of the Hyaluronic coated TEVG as identified in Figure 16.
  • Hyaluronic acid coated decellularized TEVG implanted in the dog carotid artery animal model was a challenging model that further suggest clinical feasibility of hyaluronic acid coated vascular grafts.

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Abstract

La présente invention concerne des compositions anti-thrombose comprenant des greffons vasculaires anti-thrombose. Dans certains modes de réalisation, les compositions comprennent un tissu décellularisé revêtu d'un revêtement anti-thrombose. La présente invention concerne également des procédés de préparation de compositions anti-thrombose et des procédés de traitement comprenant l'implantation des compositions anti-thrombose dans un sujet en ayant besoin.
PCT/US2014/038597 2013-05-20 2014-05-19 Greffons anti-thrombose WO2014189835A2 (fr)

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CN201480029024.8A CN105228665A (zh) 2013-05-20 2014-05-19 抗血栓形成移植物
AU2014268778A AU2014268778B2 (en) 2013-05-20 2014-05-19 Anti-thrombogenic grafts
CA2912664A CA2912664C (fr) 2013-05-20 2014-05-19 Greffons anti-thrombose
EP14800261.1A EP2999494B1 (fr) 2013-05-20 2014-05-19 Greffons anti-thrombose
ES14800261T ES2829412T3 (es) 2013-05-20 2014-05-19 Injertos antitrombogénicos
DK14800261.1T DK2999494T3 (da) 2013-05-20 2014-05-19 Anti-trombogene transplantater
US14/783,897 US9981066B2 (en) 2013-05-20 2014-05-19 Anti-thrombogenic grafts
HK16107327.1A HK1219242A1 (zh) 2013-05-20 2016-06-23 抗血栓形成移植物
US15/963,750 US20180243482A1 (en) 2013-05-20 2018-04-26 Anti-thrombogenic grafts
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US11191872B2 (en) 2016-04-27 2021-12-07 Yale University Compositions and methods for grafts modified with a non-thrombogenic and pro-migratory cell-derived extracellular matrix
WO2020172162A1 (fr) * 2019-02-19 2020-08-27 Tc1 Llc Greffon vasculaire et procédés de scellement d'un greffon vasculaire

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US9981066B2 (en) 2018-05-29
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US20180243482A1 (en) 2018-08-30

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